Paying for Quality Care: Implications for Racial and Ethnic Health Disparities in Pediatric Asthma

Abstract

Children who are from racial and ethnic minority groups, are of low income, or are both are affected disproportionately by asthma. Despite advances in the treatment and management of asthma, including the development of guidelines for clinical practice, substantial racial, ethnic, and socioeconomic disparities exist in both health care quality and health outcomes. Financial incentives generally have the potential to improve overall quality and, when targeted specifically toward disparity reduction, may be able to help close the quality gap. For this strategy to succeed, however, efforts must be made to eliminate fundamental access barriers created by uneven, unstable, and seriously constrained health care financing for low-income children.

Relationship Between Presence of a Reported Medical Home and Emergency Department Use Among Children With Asthma

“…Finally, the consistently documented association between health insurance and receipt of quality primary care in a medical home suggests the need for actions and reforms to maximize coverage but also to provide financial incentives to pediatric primary care practices through improved reimbursement mechanisms (AAP & Medical Home Initiatives for Children With Special Needs Project Advisory Committee, 2004, AAP Committee on Adolescence and Committee on Child Health Financing, 2009;James & Rosenbaum, 2009).…”

A tale of two systems: practice patterns of a single group of emergency medical physicians in Taiwan and China

“…Different patterns for prescribing steroids between Xiamen and Keelung may indicate potential differences in culture and people’s attitudes toward specific medications in Taiwan and China. Previous studies revealed national and racial disparities in the patient’s knowledge about asthma and its management [ 11 , 12 , 37 – 39 ]. South Asia parents tended to believe that inhaled corticosteroids did more harm than good when compared to the beliefs of Caucasian parents (OR 3.19, CI 1.22-8.34) [ 37 ].…”

Patient perceptions of asthma-related financial burden: public vs private health insurance in the United States

“…Path models are a useful method for assessing explanatory mechanisms with observed variables, and path is adjusted for all factors included in the model. 14 All equations were estimated simultaneously with Mplus 6.12 software. P-values of 0.05 or less were considered statistical significant for these analyses.…”